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How to Be Prepared for the Unpreparable Emergency Room Visit

As a parent, you know the importance of being prepared for medical needs.

And yet, as you also know, you can’t often prepare for the things that will need medical attention.

  • The bumped head after she trips over a hoola-hoop.
  • The slammed thumb in the car door.
  • The incessant puking or wheezy cough in the middle of the night.

Furthermore, there are just some things that are bigger than the ice packs and bandaids we keep close by. At some point, your child may need medical attention beyond what you can provide–a thought that almost always feels incredibly overwhelming.

Here’s the good news though: You can prepare for the unpreparable too.

And to help us, we’re going to go to the experts: Those hospital professionals who can tell you exactly how to prepare as well as what to expect when you walk through the doors on your first Emergency Room Visit.

I reached out to two of my favorite people—an emergency room director/nurse and patient access director—to get their take on what parents can do to feel more confident and prepared when going to those unexpected emergency visits.

With a few of their tips as well as a few of mine (our family mantra this year is “No concussions in 2018!”), you can be confident that, although trips to the emergency room are never something we schedule out, we can still prepare for them ahead of time.

Here are some basic ways you can tackle the unknowns, be prepared for the unexpected, and take on that emergency room visit like the boss you truly are!

But First…
What Exactly Should Require
an Emergency Room Visit?

Before we dive into tips on how to prepare yourself and your child, let’s first answer the question of when you should make an emergency room visit.

If you are in a crisis situation and questioning whether or not you should head straight to the emergency room, there are a few resources to help you make that decision.

When-To-Go Resource #1: Call Your Pediatrician

While they can’t give you a diagnosis on the phone, they can help you determine the expediency with which your little one needs to be seen.

When-To-Go Resource #2: Utilize Technology

No, not Google.

Many insurances also now have a low- or no-cost e-physician as an option through an app to video chat almost immediately. This has saved my family a ton of money through flu and cold season. They can diagnose and prescribe right over the phone or computer at 2 a.m., and you won’t have to drag anyone out of bed to do it. And they can let you know if you need to head to the emergency room straight away (though if still in doubt – go).

If you choose to go the e-doc route, make sure it is a reputable app or agency and is approved by your insurance. There are many fly-by-night companies trying to do this that do not have any board-certifications and can give bad advice.

When-To-Go Resource #3 – The Good Old Fashioned Chart

There are some basic guidelines of when to go to an emergency room vs. pediatrician vs. urgent care, and you can review this chart or this one to see which of those three places would be a good option for your child’s need.

Basic rule of thumb, though, says to go the emergency room if your child:

  • Is less than 2 months old and has a fever of 100.4 degrees Fahrenheit or higher.
  • May have a broken bone, with swelling or protrusions.
  • Hit her head and appears to pass out or lose consciousness for a few seconds.
  • Had a seizure.
  • Has signs of dehydration.
  • Is having problems breathing.
  • Has gaping cuts on her face.

When-To-Go Resource #4: Your Mama Gut

When you aren’t sure, if something seems off, go with your gut and get him checked out by a medical professional. That parent instinct is real.

Now, back to being prepared…

Emergency Room Visit Tip #1:
Put Together an ER Folder

Just like you made a list of what you would need at the hospital when you were getting ready for delivery, you will need to bring certain things to the emergency room as well even if you are in a hurry.

Let’s talk about the things you should have ready at a moment’s notice versus those things you might want to bring if you have a little more time on your hands.

10 Things You Need to Prepare Right Now

If you have to head immediately to the emergency room, you will need specific paperwork and information available. Get that ready now. Make copies and toss them in a document organizer like this one.

Here’s what you should gather together this weekend:

  1. Insurance Cards
  2. Name, Birthday, Contact Information, and Social Security Number of the Insurance Guarantor (normally the primary insured person)
  3. Your Driver’s License
  4. Child’s Birthday and Social Security Number
  5. List of Medications, Vitamins, and Supplements. If possible, bring the actual medications with you.
  6. Known Allergies
  7. Any Current or Past Medical Conditions
  8. Emergency Contact Information
  9. Primary Care Doctor’s Name and Phone number, as well as any specialists your child sees regularly
  10. A Small Notebook—to write down questions, things the staff tells you, times medications are taken, etc. Hospitals are all about checking and checking again, so don’t be afraid to ask what medicine is being given and how much and write it down.

Having all these together will make the check-in process easier and help mitigate any billing issues later on.

Pro Tip! Do a Pre-Check and Save Yourself Waiting Time

Some hospitals allow you to do a “pre-check” which allows you to go at any time to get your insurance and contact information entered in the system which will make the times of emergency easier.

Others even have the option of connecting all your medical records to a fingerprint or hand scan, in case (God forbid) you or your child show up at the hospital unconscious or unable to communicate or if a caregiver brings them in and doesn’t have all the information.

Note from emergency room director and nurse Devry:  “During your visit, you will be asked why you are here multiple times by multiple people–this doesn’t mean we don’t communicate. We want to hear it from you because, very often, peoples’ stories change and they remember different things as time goes on.”

Emergency Room Visit Tip #2:
Gather a “Good to Have” Bag

If you have a little more time, be sure to grab her lovey and some play items in addition to your everyday mom bag. Depending on how many patients are at the emergency room and how urgent his problem is compared to others being seen, you may wait a bit, both in the lobby and once you get checked in.

You can do yourself a HUGE favor by gathering up a few items to make you feel human again after a few hours in the emergency room…or in case your child actually gets admitted.

8 Things You’ll Be Glad You Grabbed

  1. Comfort Items—Whether a favorite blanket, stuffed animal, or toy, bringing “huggable” items that make your son feel safe—and provide a sense of familiarity—is key.
  2. His Favorite Cup—While the hospital will have straws, something about having a familiar item so close to his face helps. If you don’t have one, this R2D2 thermos is a favorite at our house.
  3. Books, Toys, Coloring Books, and Games (like the Sneaky Snacky Squirrel)—Pack them all in an awesome bag that is easy to carry with hangable handles, a zip-top in case it tips over, and a material that can wipe clean (or wash) to get off all those hospital germs.
  4. Yoga Pants & Comfy Clothes—I’ve sat through the night in a hospital chair in jeans, and I’m not doing it again. Fortunately, Lauren has tips on how to make yoga pants actually look fashionable in less than five minutes.
  5. Warm socks for Both of You—It can get cold, and if you take off your shoes to crawl in bed, you don’t want bare feet on those floors, no matter how often they clean them.
  6. Freshen-up Kit—Having a Freshen-Up Kit (e.g. face wash, brush, toothbrush, mascara, etc.) is always helpful to have tucked in the car or the diaper bag, especially in emergency situations like this one!
  7. Lip Balm—Never forget the lip balm.
  8. Snacks for You—Some hospitals have a wonderful little hospitality room for parents overflowing with yumminess, or at least PB&J and cheese sticks. Others…don’t. While your son’s food will be strictly monitored and attended to, you may be left to fend for yourself. Bring snacks and a water bottle (And, if they don’t have coffee at that hospital, leave immediately – you don’t want to be there. Just kidding. They all have coffee.).

Devry says, “Don’t hesitate to ask the staff for food or water if you need anything. They may not always remember to offer it, but they don’t ever want you to be in need. If you need to go to the restroom, let us know so we can watch your child. We are a team.”

Pro Tip! Your Child’s #1 Comfort Item Is…

While all these things are important to have, remember that his #1 comfort item is YOU. Be present with him. Pay attention to him and keep him entertained and calm so he will have an easier visit and less fear.

Parents who ignore their children and play on their phones throughout the visit increase the child’s anxiety and increase boredom which can lead to outbursts. Right now, what he needs most is your attention–even after several hours.

Especially after several hours.

Emergency Room Visit Tip #3:
Mental Prep to Keep Anxiety Away

While your daughter has probably been to a doctor’s office before, the sights and sounds of an emergency department are something else entirely and are likely to be incredibly overwhelming.

Expectations can be your worst nightmare or your best friend. To help ease her initial fears and impressions, there are a few things you can do with her now to make things more familiar should you find yourself driving to the hospital some day.

Read Books and Watch Videos

There are numerous children’s books and television episodes that can help your daughter understand that doctors and the emergency staff are there to help. You can teach her in advance that, while she may experience a little pain (and a little boredom), she will ultimately be there to get better.

Character books on the topic abound, from Daniel Tiger and Biscuit, to Curious George and Paw Patrol. Not to mention the undisputed Queen of Calm in the Emergency Room, Doc McStuffins. Make sure to bring these with you if you do go to the emergency room!

Use Everyday Object Lessons

It is always exciting to see a fire truck or ambulance go by; use these times as an opportunity to talk about how the emergency responders are going to help someone.

Go further by asking him what he thinks might be wrong with the person, how that patient would get help, and what he thinks the inside of an ambulance looks like. No answer is wrong; it is just a chance to get him thinking about it.

This is also a good time to teach compassion as you pray for the first responders and patients.

Engage in Imaginative Play

Play hospital with your child and take turns being the doctor, nurse, and patient while engaging her stuffed animals as well. Come up with both silly and serious ailments and incorporate lots of laughter.

A little medical kit will help her become familiar with the various tools she will see at her visit, and she is more likely to be compliant when a nurse tries to monitor her heartbeat. Plus, it is fun watching the doctor’s surprise when your child asks to see the otoscope.

Once you play it a few times, you will notice she will start playing it on her own, and reading her new books to her stuffed animals so they also won’t be scared.

Still, Expect Fear

You can try every strategy in the books and then some, but it’s likely that when faced with an emergency situation, your child will still be anxious and fearful.

Not to worry. I can promise you this: The staff at the hospital has seen this. This ain’t their first rodeo.

Your son’s behavior is completely normal.

According to Devry, “The doctors, nurses, and techs in the emergency department are expecting your child to ‘not do what we ask.’ We understand they are afraid of what might happen, and we are strangers to them. So never be embarrassed about how they act.”

Even my daughter who lives and breathes unicorns would have no idea what to do if a flesh-and-blood unicorn walked up to her in real life. But her knowledge of it would help her adapt faster. The same goes for an emergency situation.

Emergency Room Visit Tip #3:
Think Through the Big Picture

If you aren’t already familiar with the hospitals in your area, doing a little research before an accidental emergency room visit will go a long way.

First, map out the closest hospitals and pediatric urgent cares to where you live, work, and play. Make sure everyone in your family and any caregivers know where they are. In fact, you may want to print them out and put them in your little ER organizer!

Then, do a little research on facility abilities, specialties, rankings, and cost to determine your favorites. Many areas have not only more than one hospital close to them, but more than one hospital system.

Here are the basic questions you should ask:

  1. What hospital does your pediatrician prefer?
  2. How are the hospitals ranked in US News & World Report?
  3. What are the Leapfrog Safety Ratings of each hospital?
  4. Which hospitals and emergency room physician groups take your insurance?

Then dive a bit deeper with some of these larger questions…

Does the Hospital Have a Specific Pediatric Wing?

In other words, is there a children’s hospital or urgent care around, or is there a hospital  with a children-specific treatment area? What pediatric specialties are available at those hospitals?

The extra touches and additions at pediatric-only facilities vary by location and hospital system–obvious things like colorful patient rooms and more toys, and more care-focused amenities like a child-life specialist on staff, child-focused distractions for imaging services like MRI or CT (MRI movie goggles are great!), and more experience with distractions for giving shots or medicine.

Is it an Urgent Care or Freestanding Emergency Room?

A somewhat recent trend has fully-staffed emergency rooms popping up all over, unattached to a traditional hospital with inpatient beds. While these are typically almost identical to the conventional emergency room and are really great, they can sometimes be mistaken for an urgent care.

To make sure you are going to the right place—and so there is no unexpected hit to the wallet—make sure you know which is which.

Is the Hospital For-Profit or Not-for-Profit?

All political and economic arguments aside, if you don’t have insurance, or if you’re using state-sponsored insurance like Medicaid, this question becomes really important.

Hospital charges will generally be more at for-profit hospitals, and not all for-profit hospitals take Medicaid. Additionally, not-for-profits are typically much more willing to work with any outstanding payments than for-profits.

With insurance, there shouldn’t be much of a difference in your deductible, but percentage-based copays can be affected as for-profit hospitals may charge more.

There are some for-profit hospitals that really go out of their way to help people financially, and some not-for-profits that are not-so-great about it.

While cost shouldn’t be the deciding factor on where you go, it is always good to know.

This will vary by area and hospital system, so talking with your insurance company as well as other parents/patients about their experiences is important.

You Did It!
You’re Prepared for the Unpreparable!

While trips to the emergency room can be absolutely daunting for you and your family, the process itself doesn’t have to be.

By setting aside the proper paperwork, helping little hearts prepare for what to expect,  and getting peace of mind about your hospital of choice, you have made leaps and bounds in helping any potential emergency room visit go as smoothly as possible.

Once all the basics are taken care of, you can focus on your child’s needs and be the comforter and medical advocate he needs.

So now, deep breaths.

You’ve got this.

Have You Read These Yet?

Big thanks to the experts who helped make this article possible—Devry Aldaz, MSN, RN, CNML and Joan M. Ramos! Your passion and commitment to excellence literally help save lives every day. Also special thanks to Jake Flinkman, ER Doc Extraordinaire for adding his thoughts and suggestions!

We 
Citations

Urgent Care vs. The ER. CentraCare.org
Doctor’s Office vs. Urgent Care vs. The ER. WellMedicalCenter.com
Should You Go to the Emergency Room or Urgent Care? Scripps.org
Urgent Care Versus the ER: A Pediatrician Offers Tips on Making the Right Choice. HopkinsMedicine.org

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